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13100012
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11518 CHARSAN LN CONTRACTOR:DOLLENS ELECTRIC . PERMIT NO:13100012 CORPORATION OWNER'S NAME: SU PHILIP AND CHEN MICHELLE MEI LIE 3591 PINE RIDGE WAY DATE ISSUED:10/01/2013 OWNER'S PHONE: 5105790049 SAN JOSE,CA 95127 PHONE NO:(408)929-6100 13 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class e�b Lic.# 1J /3 7( INSTALL EVC STATION LOCATED IN GARAGE 9.6KW Contractor �P �s �t'Q !C�7G Date l� I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$500 I have and will maintain Worker's Compensation.Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36210052.11518 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 18,4 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS M LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued b Date: ` granting of this permit. Additionally,the applicant understands and will comply y' with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. J RE-ROOFS: Sign atu Date ` All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,.I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from-the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued.. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent- Date: ! permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address - I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes..(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertinoagainst liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the.applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION A0DDRESS: DATE: 10/01/2013 REVIEWED BY: MENDEZ APN: BP#: `VALUATION: $500 } *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Du lex PENTAMATION SOLAR-RES USE: p PERMIT TYPE: WORK INSTALL EVC STATION LOCATD IN GARAGE SCOPE r Xfeelt. Plan Check Plumb.Plan CheckElec..Plan Check L1i>r.;h.Permit Fee: Plumb.Permit Pee: Elec. Permit Fee: Other Afech.Insp, Other Plumb Insp. Other Elec.Insp. .tlech. Insp.Fee: Plumb, Insgr.Fee: Elec,Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc-). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'1 info, FEE ITEMS(Fee Resolution 11-053 E . 7� /f 1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-7-1 # Alternative Energy System Suppl.PC Fee: O Reg. OOT 0.0 hrs $0.00 $106.00 1CHRGSTA EV Charging Station PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.0 Reg. O OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative.Fee: Work Without Permit? O Yes (j) No $0.00 O Advanced Planning Fee: $0.00 Select a Non-Residential O Building or Structure O Travel Documentation Fees: A Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 u $1.50 $106.00 ,0 $107.50 Revised: 08/01/2013 core : e h Ek d L ho Sub- _ ;iY I panel 2:s 200A "OMNI 2 0 0 TIC- pirg of this piz-,.n, spec;fic,,-,.tions SHALL NOT Ll N L2 G [-,e�d to pemit or to be an approval of the violation of any Apvi lloin§of any City Ordinance or State Law. 140A, 40A CO> EV Charging Dock L BY _ J Aerovironment DATE 1113- Model EVSE-RS C> PERMIT NO. IZ,117Z) NOA GFP 0J ZO 8awg twhn-2 ampacity 55A Gnd 10 ga. 200 amp panel approx 35ft SR# Customer hilip Su 1518 Charsan Lane Garage 20' PLOT PLANS pertino, a,95014 Project Date evse rs - charging dock CHECKED BY EV Chargln Dock 9/4/13 40amp-240-volt PATE AQ/I t Prepared by J. Dollens 1 of 1 LAIC I EPT. Main Garage Door DATE Troubleshooting - Panel Upgrades • Solar Power 408-929-6100 - fimpower.com http://database.W.Com/cgi-bin/XW/template/USEXT/1FRAME/showpa,.. FFWA.E336193 Electric Vehicle Supply Equipment Pag Bo om Electric Vehicle Supply Equipment Se General Information for Hec+.a-vphi 1� ooR ra omen+* AEROVIRONMENT INC 1610 S MAGNOLIA E336193 MONROVIA,CA 91016 USA EV merging station,Model EVSE-RS. 115JJU2d&teAJ on 2010-09-07 dons? _ Print 9115 Dong Notice ofd mer Page Too ConvHaht(c7 2010 IR.rp HC��,b rat•nripc T The appearance of a company's name or product In this database does not In Itself assure that products so Identified have been manufactured under UL's Follow-Up Service.Only those products bearing the UL Mark should be considered to be Listed and covered under UL's Follow-Up Service.Always look for the Matic on the product. UL permits the reproduction of the material contained in the Online CetthIcation Directory subject to the following conditions: I.The Guide Information,Designs and/or Llstlngs(files)must be presented In their entirety (or drawings).2.The statement"Reprinted from the Online Certifications Directory�y�non-misleading from manner,without any manipulation of the data appear adjacent to the extracted material.In addition thererY e a copyright from Underwriters Laboratories Inco must 2010 Underwriters Laboratories Inc.®• Printed material must include a copyright notice in the following format: "Copyright An independent organization working for a safer world with integrity, precision and knowledge. 7 '1 10/26/2010 12:05 PM t � i r• 1 I , i E t E� 1 .a, �.y sr. �v" cL "'y-�w...� ,w:: `n�i-.• '.F�'- -- '`.res. rf N 4 v _ For Munici ` � 1 1 p �Weq"( of E I E i i © 2010 AeroVironment, Inc. All rights reserved ' M1 r 3 s INSTALLING THE EVSE—FSS � Basic Specifications: ®For use with Electric Vehicles ®Ventilation not required ®Rain tight :Numberof Ft-eq Hz Voltage AC CUrrent Operating ' 'Phases Amps Temp 1; i0 208-240 30 . 30 tp +50 l I Power Disconnect switch Charging Dock distribution (if applicable) panel I Wall stud j Ti �! ' I � t I i t �' 1 . Choose wire entry location HOLE IN REAR OF HOLE ON UNDERSIDE OF CHARGING DOCK CHARGING DOCK ff t i '.Til Bottom View Rear`Aaw 2. Attach the mounting plate Mounting plate a G O Large hole for conduit utility wires o Small holes for Charging Dock mounting holes mounting plate eto wall stud O Flat washer Lag bolt Wall stud O O e--- ----------------- @------- 00 l----- ---------------- ------- 4W O Wall stud i 3. Attach the Charging Dock to the mounting plate i Upper mounting hole Flat washer Socket head screw ' I / , •�- -- --------�p�------------emu i (S 1 4. Wire the Charging Dock F 13 / c � E Terminal Blocko , E 9 Y Ground Strip Ground Wire r/ E '`- i Two pourer wires E t c 1 f r r 5. Install the front cover #10 Torx screws—Torq ue 12in/Ib I E IJ mroa u ter. 4M - \ i Removingthe trim ring g Ac,as;1Wi Wei nrq 5. Complete the installation E -------------- n, - FRONT PANEL- COMPONENTS s POWER PRESENT I he charging dockis receiving AC pov-r. START READY TO CHARGE Press to begin a charge.,;-,e The changing docl-i�ready to pcsERpr�er=o F-0�.ER URESEIN11 and REACY charge or charging is paus-d. �yToc y =Q O RT T�CNr� GE tiah<ru> b_:,n. SCO»o ST P o TROIE 8 VE46CLE CONNECTED STOP Fre>s to manually stop chargincl. i a connectori<_property connect=d to the vehicle port i:,e device-will stop automatically _.the char_aa is completo. -i.-hen it reachTs fuli._harg<. , j VEE C E CHARMNG ! T hc,:,ehide is h-ming charged. TROUBLE Ther .i s an error. Try remo-rng the c un=ctar and ins_riing back into the vahidc.If Trouble Indicator is still iliur inated call Customer erFir_e at 1;S%;j NO t GA.13 EV or 1 i&F 7)664-2738 or =sic QJstol-ner Service on the R€LBUTTON viab atr.,,v;.nr==_anus3.corr»feaf. Frass tto o r_3ea3e the C-cnnsctor frcrn the chargirn:i dockorthe vehicle('.Ori. V i It 114 8 CHARGING THE VEHICLE f g"0 t Puss the budcn nm the ronnsew to r_'t?we-it aca ;d the Ftw K— fro m the rhn4gq&PA f 1 VEHICLE CONNECTED 0 I icn�enei ear'p lnsartcJnnect"rtlrniyinto dic, r wrzeaxst o STAW C:haraltag�r_N t_�in vehicle ch-x�port 6JOytmsertad,the VEHICLE vrx»scout �g chwgriq begns.the CONNECTED I:g1•tt on the `t"B`E° '- FHICIECH,RGINC.Itnht j charging dRrr k w ill ilktmutata. tiif br-gin to Mini`Rje- i( iS;o nead t,.suras. 'Ti1F;1. I 1 f VEMCLE CHARGING 01 } f1>sTJHR Ghargmq-will stop automatic-illy t`uhamFh4 L iii_!s • ATOP when cotrpl-ste. You ejn manualky CIJARU G!I-:,t st_tps stop sh.-mrig by pneszing&71 OP. tLn�lnq•,n th- hsrger. ! Whan the READY TO CRARGE light bliriks,remove thy comns.tor emn= tt, .r is,r=spas_. from thavefti%W_charge port_if Pull to renin,,from you hiTee pryssad STUE,ycw can pr,ass START to resums charging. E { 7 I � • � s s • se I ; The EVSE-RS Home Charging Dock charges all SAE J1772-compliant FEATURES vehicles—including both electric ' vehicle(EV)andg-�p lu In hybrid • SAE J1772 compliant (PHEV)models—in the convenience of the home garage,workplace, Auto restart in event ofpaweroutage or condominium,apartment,or retail ground fault parking structure.The Home Charging Americans with Disab#Rtes Act{ADA) Dock safely and reliably delivers compliant installationr :> AC power to the vehicle's on-board • Integrated cable stowage,optional charger and features aweather - cable managementresistant NEMA 4 enclosure for indoor • Underwriters Laboratog1M)#fisted and outdoor installations. Pre-production(mage shown. • Breakaway safety cable Production model may vary. -Optional pedestal mount •'Wireless communication option The Home Charging Dock is installed by one of our independent certified licensed electricians who also facilitate necessary permitting and inspection, and provide information about EVSE-RS use to the customer.An optional SERVICE AND 1NSTAL;LAT(01r1 module is used to enable WiFi,Zigbee,or cellular communication. Will be supported by. o Expanding network of,9rtdeper dent certified,trained eledritiaht INTUI`IVEUSERINTERFACE • Convenient home site-assessn3;ents GREEN=utilityuohage connected and installation GREEN:readyto operate . GREEN BLINKING="ofif sfate due to a manna{STOP. • Electricians with deptkt # c of oal',cade and >`GREEN connected to vehicle permitting knowledge; GREEN=vehicle is charging ifast blinking=high charge when battery is low,x1611 blinking=charge near complete) RED=errorllas occurred;blinkid4ipattern based on fauittype 'Installation services available in certain areas;contact AV for additional information. 62010 AeroVironment.Inc. H&8312148 1010 10147 • SPECIFICATION EVSE-RS Connector SAE J1772 Voltage 208VAC to 240VAC Frequency 50Hz/60Hz Current 30A max Operating Temperature -30°C to 50'C Storage/Transit Temperature -40°C to 60"C Humidity Up to 95%non-condensing Dimensions 12"x 12"x 8"(approximate) Weight 10 lbs.(excl.cable) Cord Length Up to 25'available Enclosure NEMA 4 Regulatory Compliance UL listed,CSA and CE pending Information and specifications subject to change 02010 AeroVironment.Inc. er 20 t 1010_10147 (Project Name) Philip Su 3374 11518 Charsan Lane, 2a3i YA Cupertino,Ca,95014 �; 1 �? d0UA Telephone&Fax r s 5 ton 7,130 VA 5kW1 r t p`p A/C#2 VA 9.6 kW aY,2U0,Vi4 1 9,530 VA �� A/C#3 Select 2 't A/C#4 ayq. Select Qty r 11,890 VA A/C#5 Select Qty - GAS 1,400 V 1s1}40 800 VA UA' 1,030 V 1 "0301,VA 7,200 VA 1,587 t• 1,200 V 1h2b0 /4 31,626 VA 1,700 V 1 h 1 TOU�(A 1,440 V UA Demand Load 240V,1ph 132 A 288 VAS VA 400 VAS VA Neutral Demand 84 A x 12,000 1,500 V 0 p ;� VA` MIn.Service Req. 150 select V{l. sale ct � V4, to<<<Yq Min.Feeder size 1 seleMin.Neutral size 4 selects Cond. 6 s 0 .: R 7,200 W Pool Panel Feeder Calculation (see Note) A B N y � � E a 0 ...... 0 select m select .. = select �, select � select � 'select � , _ select 0 select select select 0 Al40v 0 `. �o aoV 0 0.0 FYN; . .,4 0, 40v 0 :. , in.Co er Pool Feeder AWG A ARM Minimum Panel Ratin A Phase Amperes Neut.load